How is your mind-set? Proof of concept for the measurement of the level of emotional development

Background In persons with intellectual and developmental disabilities, not only cognitive brain functions, but also socio-emotional processing networks may be impaired. This study aims to validate the Scale of Emotional Development—Short (SED-S) to provide an instrument for the assessment of socio-emotional brain functions. Method The SED-S was applied in 160 children aged 0–12 years. Criterion validity was investigated at item and scale level in terms of the agreement between the scale classification and the child’s chronological age. Additionally, interrater reliability and internal consistency were assessed. Results For the majority of items, the expected response pattern emerged, showing the highest response probabilities in the respective target age groups. Agreement between the classification of the different SED-S domains and chronological age was high (κw = 0.95; exact agreement = 80.6%). Interrater reliability at domain level ranged from κw = .98 to 1.00 and internal consistency was high (α = .99). Conclusion The study normed the SED-S in a sample of typically developing children and provides evidence for criterion validity on item, domain and scale level

A brief version of the Scale of Emotional Development – Short

Background The Scale of Emotional Development – Short (SED-S) captures the level of emotional development in persons with a disorder of intellectual development (DID) with 200 items on five developmental levels. The study aims to develop a brief version of the SED-S. Methods Based on item analysis (proportions, χ2-test, Spearman's ρ and corrected item–total correlation), a brief version of the SED-S was developed in a sample of 224 adults with a DID (n1) and validated in a second independent matched sample (n2 = 223). Results Item reliability ranged per item set from Cronbach's α = 0.835 to 0.924. Weighted kappa resulted in κω = 0.743 (P < 0.001, 95% confidence interval = 0.690–0.802). Overall agreement of the brief version with the original SED-S was PO = 0.7. The brief version of the SED-S showed weaknesses in distinguishing level 2 from the adjacent levels. Conclusions The brief version of the SED-S showed good reliability and moderate to good validity results. Items of phase 2 and, to some degree, of phase 5 should be revised to further improve the psychometric properties of the scale.Peer Reviewe

Diagnosing autism in adults with intellectual disability

Bei jedem 4. Menschen mit Intelligenzminderung (IM) besteht zusätzlich eine Autismusspektrumstörung (ASS), die häufig bis ins Erwachsenenalter unerkannt bleibt. Voraussetzung für die richtige Behandlung der ASS und der damit oft assoziierten, schweren Verhaltensauffälligkeiten ist die differentialdiagnostische Abgrenzung gegenüber anderen psychischen Erkrankungen und der geistigen Behinderung selbst. Ziel der vorgestellten Untersuchung ist, die Diagnostik bei erwachsenen Patienten mit Intelligenzminderung und Autismusverdacht zu verbessern. Dazu werden die in der Kinder- und Jugendpsychiatrie etablierten Untersuchungsinstrumente auf ihre Anwendbarkeit bei Erwachsenen mit IM überprüft und angepasst und spezifische Verfahren entwickelt. Während der Fragebogen zur sozialen Kommunikation (FSK) - aktuell mit einem veränderten cut-off von 18 auch bei erwachsenen Menschen mit IM angewandt werden kann, kann die Durchführung des FSK-Lebenszeit bei erwachsenen Menschen mit IM nur eingeschränkt empfohlen werden. Die Diagnostische Beobachtungsskala für Autistische Störungen (ADOS) und das Diagnostische Interview für Autismus-Revidiert (ADI-R) sind nur bei 68% bzw. 37% der Patienten anwendbar gewesen. Während die ADOS eine hohe Sensitivität von 100% und eine niedrige Spezifität von 45% aufweist, zeigt das ADI-R balanciertere Werte von 88% bzw. 80%. Anpassungen im Setting, in den Aufgabenstellungen und im Auswertalgorithmus können die Anwendbarkeit und die psychometrischen Eigenschaften der ADOS weiter erhöhen. Eine ICD-10 basierte Autismus-Checkliste (ACL) wurde für Ärzte und Psychologen entwickelt und zeigt eine akzeptable Validität und Reliabilität. Zur Einschätzung der Autismus relevanten Verhaltensweisen im vertrauten Lebensumfeld der Betroffenen wurde ein 4-stufiger, 20 Items umfassender Diagnostischer Beobachtungsbogen für Autismusspektrumstörungen (DIBAS) für nahe Bezugspersonen entworfen, überprüft und in überarbeiteter Fassung (DIBAS-Revidiert) prospektiv validiert. Die emotionale Entwicklung war bei erwachsenen Menschen mit IM und Autismus im Vergleich zu Menschen ohne Autismus signifikant verzögert und inhomogen. Das Profil der emotionalen Entwicklung kann bei der Autismusdiagnostik hilfreich sein (Sensitivität 78%; Spezifität 76%) und ist für die Entwicklung und das Verständnis von Verhaltensauffälligkeiten bedeutsam. Die Anwendung der adaptierten bzw. neu entwickelten Diagnostikverfahren für erwachsene Menschen mit IM trägt zur Verbesserung der medizinischen Versorgung dieser vulnerablen Patientengruppe bei, die einer besonderen ärztlichen Zuwendung bedarf.Individuals with intellectual disability (ID) are at risk for additional autism spectrum disorders (ASD). One in four individuals with ID is diagnosed with additional ASD. However, ASD often remains unrecognized until adulthood. Carefully diagnosing ASD in affected individuals would allow for more tailored clinical interventions that would improve mental health and quality of life. The aim of the present study was to optimize the diagnostic process for adults with ID and suspected comorbid ASD. Hence, ASD diagnostic instrument established in children were examined, adapted and new, specific instruments for adults with ID and suspicion of ASD were developed. Our findings support the use of the Social Communication Questionnaire-current for ASD screening in adults with ID (cut-off: 18), while the Social Communication Questionnaire- lifetime should be used with caution in this population. The Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R) were applicable in only 68% and 37%, respectively. While the ADOS showed a high sensitivity (100%) and low specificity (45%), the ADI-R revealed better balanced results (88% and 80%, respectively). Adjustments of the setting, the tasks, and the algorithm may further improve the feasibility and psychometric properties of the ADOS. An ICD-10 based Autism-Checklist (ACL) developed for physicians and psychologists showed acceptable validity and reliability. To systematically assess ASD relevant behaviours in a familiar environment, the Diagnostic Behavioral Assessment for ASD (DiBAS) was developed, evaluated and validated in a revised version (DiBAS-Revised). The level of emotional development was significantly lower and uneven in adults with ID and ASD compared to adults with ID alone. The profile of emotional development can be used for predicting ASD group membership (sensitivity 78%, specificity 76%) and is of importance for the development and understanding of challenging behaviours. Application of the adapted and newly developed diagnostic ASD measures for adults with ID may improve mental health in this highly vulnerable population

GROUP COMPARISON OF THE SED-S IN PERSONS WITH INTELLECTUAL DEVELOPMENTAL DISORDERS WITH AND WITHOUT AUTISM SPECTRUM DISORDER

Hermann H, Sappok T. GROUP COMPARISON OF THE SED-S IN PERSONS WITH INTELLECTUAL DEVELOPMENTAL DISORDERS WITH AND WITHOUT AUTISM SPECTRUM DISORDER. In: Special Issue: Mental wellbeing and intellectual disability. Journal of Intellectual Disability Research. Vol 67. Hoboken: Wiley; 2023: 939-940

Autism Spectrum Disorder, Intellectual Disability, and Emotional Functioning: Relatedness and Particular Impact on Challenging Behavior

Aims: Persons with an intellectual disability (ID) show high rates of challenging behaviour (CB), especially in cases of co-occurring autism spectrum disorder (ASD). The aim of this retrospective study was to examine the relatedness and impact of ASD, the severity of ID, and the level of emotional functioning in CB. Methods: The study was conducted at a special outpatient unit (clinical sample) for adults with ID and comorbid mental or serious behavioural problems (N = 560). The assessment of ASD, level of ID, and emotional functioning was part of the regular clinical assessment process. The Scheme of Appraisal of Emotional Development (SAED) was used to measure emotional development (ED) and the Aberrant Behaviour Checklist (ABC) for CB. A correlation analysis and the Mann-Whitney test assessed the relatedness of ASD, ID, and ED (N = 560). A multiple regression analysis was computed to determine the effect of ASD, the level of ID and of ED on the severity of CB (n = 278). Results: ASD significantly correlated with the severity of ID (r = .205*) and lower levels of ED (r = -.354*). This decrease occurs EAMHID ABSTRACT BOOK 173 independently of the level of ID. Multiple regression analysis revealed the level of ED to be the most important predictor for CB (n = 278; OR = −5.97, 95% CI: −9.81; −2.14). Conclusion: For persons with ID and ASD, the level of emotional functioning has a substantial effect on the severity of CB. Thus, the assessment of the level of emotional functioning is essential to provide adequate care for adults with ID, ASD, and CB

A brief version of the Scale of Emotional Development - Short

Sappok T, Barrett B, Lutter S. A brief version of the Scale of Emotional Development - Short. Journal of Intellectual Disability Research. 2024.BACKGROUND: The Scale of Emotional Development - Short (SED-S) captures the level of emotional development in persons with a disorder of intellectual development (DID) with 200 items on five developmental levels. The study aims to develop a brief version of the SED-S.; METHODS: Based on item analysis (proportions, chi2 -test, Spearman's rho and corrected item-total correlation), a brief version of the SED-S was developed in a sample of 224 adults with a DID (n1 ) and validated in a second independent matched sample (n2 =223).; RESULTS: Item reliability ranged per item set from Cronbach's alpha=0.835 to 0.924. Weighted kappa resulted in kappaomega =0.743 (P<0.001, 95% confidence interval=0.690-0.802). Overall agreement of the brief version with the original SED-S was PO =0.7. The brief version of the SED-S showed weaknesses in distinguishing level 2 from the adjacent levels.; CONCLUSIONS: The brief version of the SED-S showed good reliability and moderate to good validity results. Items of phase 2 and, to some degree, of phase 5 should be revised to further improve the psychometric properties of the scale. © 2024 The Authors. Journal of Intellectual Disability Research published by John Wiley & Sons and MENCAP

THE INFLUENCE OF DEPRESSIVE EPISODES ON THE LEVEL OF EMOTIONAL DEVELOPMENT (ED) IN ADULTS WITH INTELLECTUAL DEVELOPMENTAL DISORDERS (IDD)

Schmidt M, Haferbug T, Sappok T. THE INFLUENCE OF DEPRESSIVE EPISODES ON THE LEVEL OF EMOTIONAL DEVELOPMENT (ED) IN ADULTS WITH INTELLECTUAL DEVELOPMENTAL DISORDERS (IDD). In: Special Issue: Mental wellbeing and intellectual disability. Journal of Intellectual Disability Research. Vol 67. Hoboken: Wiley; 2023: 969

SETTING UP INTERDISCIPLINARY WARD ROUNDS IN AN ACUTE CARE HOSPITAL FOR PERSONS WITH IDD

Hermann H, Grünfelder L, Sappok T. SETTING UP INTERDISCIPLINARY WARD ROUNDS IN AN ACUTE CARE HOSPITAL FOR PERSONS WITH IDD. In: Special Issue: Mental wellbeing and intellectual disability. Journal of Intellectual Disability Research. Vol 67. Hoboken: Wiley; 2023: 968

Validation of the German version of the DSQIID in adults with intellectual disabilities

Tarasova D, Rösner P, Deb S, Sappok T. Validation of the German version of the DSQIID in adults with intellectual disabilities. Research in Developmental Disabilities. 2024;148: 104721.BACKGROUND: An observer-rated screening questionnaire for dementia for people with intellectual disabilities (ID), DSQIID, was developed in the UK. So far, the German version has not yet been validated in adults with ID.; AIMS/METHODS: We validated a German version of DSQIID (DSQIID-G) among adults with ID attending a German clinic.; PROCEDURES/OUTCOMES: DSQIID-G was completed by the caregivers of 104 adults with ID at baseline (T1), 94 at six months (T2) and 83 at 12 months (T3). A Receiver Operating Curve (ROC) was used to determine the total DSQIID-G cutoff score for the best fit between sensitivity and specificity.; RESULTS: Sixteen of the 104 participants at T1 (15%) received a diagnosis of dementia. At T1, the scores among the non-dementia group ranged from 0 to 33 (mean: 6.7; SD: 7.65), and the dementia group ranged from 3 to 43 (mean: 22.12; SD: 11.6). The intergroup difference was statistically significant (W: 158; p<.001) (AUC:.89). A total score of 9 provided the best fit between sensitivity (.94) and specificity (.72).; CONCLUSIONS AND IMPLICATIONS: DSQIID-G total score can discriminate between dementia and non-dementia cases in adults with ID. A lower cutoff score with a higher sensitivity is desirable for a screening instrument. Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved